The Effect of Physical Activity on the Severity of Menopausal Symptoms: A Cross-sectional Study

Abstract Objective To investigate the effect of physical activity on the severity of menopausal symptoms in middle-aged women in northwest China. Methods This was a cross-sectional internet survey study. Using a snowball sampling method, 468 women aged 45 to 60 were recruited from northwest China and their demographic information was collected. We then assessed their modified Kupperman Menopausal Index (mKMI) and International Physical Activity Questionnaire short form (IPAQ-SF). Random forest (RF) was used to rank variable importance and select their optimal combination. An ordinal logistic regression model was further applied to explain the direction and relative risk (odds ratio value) of selected variables. Results The prevalence of menopausal syndromes was 74.8% and more than one-half of the participants had moderate or severe symptoms (54.3%). The Mantel-Haenszel linear-by-linear chi-square test showed a strong and negative correlation between the severity of menopausal symptoms and the level of physical activity. RF analysis demonstrated that the most significant variable associated with the severity of menopausal symptoms was physical activity level. Multiple RF regressions showed that the out-of-bag (OOB) error rate reaches the minimum when the top 4 variables (physical activity level, menopausal status, perceived health status, and parity) in the importance ranking form an optimal variable combination. Ordinal logistic regression analysis showed that a higher physical activity level and a satisfactory perceived health status might be protective factors for menopausal symptoms (odds ratio (OR) < 1); whereas perimenopausal or postmenopausal status and 2 parities might be risk factors for menopausal symptoms (OR > 1). Conclusions Physical activity has a very important effect on the severity of menopausal symptoms. There is a strong negative correlation between them. Although these findings need to be confirmed by prospective longitudinal studies, physical activity is still recommended to improve menopausal symptoms, thereby increasing the quality of life.